UBC Theses and Dissertations
Caring for individuals with concurrent mental health and opioid use disorder : a mixed-methods study with implications for health research, policy and practice Beaulieu, Tara Anne
Background: The co-occurrence of opioid use disorder (OUD) and mental illness is common and may lead to poor negative health and social outcomes, as compared with having either illness alone. The body of evidence pertaining to best practices in person-centred care for those with concurrent OUD and mental illness remains in its infancy. The objective of this project is to generate evidence to guide improvements in the provision of concurrent OUD and mental health care for this population. Methods: This mixed-methods project begins with a rapid review which assesses the current landscape of health-related measurement for this population and provides recommendations for empirical work. For the empirical work, first, data were derived from two longstanding prospective cohort studies of people who use unregulated drugs. The impact of various factors on receipt of concurrent OUD and mental health care from a single provider were examined using generalized estimating equations. Second, guided by an interpretive descriptive methodology, data were collected via semi-structured interviews with physicians and persons with lived experience (PWLE). Findings were derived in a series of iterative steps including thematic analysis, as well as theme interrogation, and reflection on plausible associations or affiliations. Results: This project highlighted key concerns with current health-related measurement practices and identified strategies to improve the quality of and opportunities for health-related measurement among this population. It identified factors which may delay or inhibit receipt of concurrent OUD and mental health care from a single provider including daily non-injection opioid use and experience of a non-fatal overdose. It then drew attention to various concerns with the present quality of care currently being provided to individuals with a concurrent OUD and mental illness. This thesis also identified strategies that may ensure the provision of high quality, evidence-informed care for this population. Conclusion: Amidst North America’s worsening overdose crisis, a coronavirus pandemic, and an era where mental health has been increasingly threatened, findings from this project offer critical insights to help guide future research, policy, and practice decisions in an optimal way to support improvements in outcomes of persons living with concurrent OUD and mental illness.
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